Time spent in bed at night by care-home residents: choice or compromise?

Abstract

This paper examines the amount of time that care-home residents spend in bed at night, focusing on how residents' bedtimes and getting-up times are managed. Using a mixed-methods approach, diary data were collected over 14 days from 125 residents in ten care homes in South East England. The findings indicate that residents spent, on average, nearly 11 hours in bed at night, significantly more time than was spent sleeping. There was greater variance in the amount of time residents who needed assistance spent in bed than there was for independent residents. Detailed investigation of six care homes, each with 8 pm to 8 am night shifts, showed that bedtimes and getting-up times for dependent residents were influenced by the staff's shift patterns. Analysis of qualitative interviews with 38 residents highlighted a lack of resident choice about bedtimes and many compromises by the residents to fit in with the care-home shift and staffing patterns. The social norm of early bedtimes in care homes also influenced the independent residents. It is argued that the current system in care homes of approximately 12-hour night shifts, during which staff ratios are far lower than in the daytime, promotes an overly long ‘night-time’ and curbs residents' choices about the times at which they go to bed and get up, particularly for the most dependent residents.

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